Choosing between measures: comparison of EQ-5D, HUI2 and HUI3 in persons with hearing complaints

Janneke P C Grutters, Manuela A Joore, Frans van der Horst, Hans Verschuure, Wouter A Dreschler, Lucien J C Anteunis, Janneke P C Grutters, Manuela A Joore, Frans van der Horst, Hans Verschuure, Wouter A Dreschler, Lucien J C Anteunis

Abstract

Objectives: To generate insight into the differences between utility measures EuroQol 5D (EQ-5D), Health Utilities Index Mark II (HUI2) and Mark III (HUI3) and their impact on the incremental cost-effectiveness ratio (ICER) for hearing aid fitting

Methods: Persons with hearing complaints completed EQ-5D, HUI2 and HUI3 at baseline and, when applicable, after hearing aid fitting. Practicality, construct validity, agreement, responsiveness and impact on the ICER were examined.

Results: All measures had high completion rates. HUI3 was capable of discriminating between clinically distinctive groups. Utility scores (n = 315) for EQ-5D UK and Dutch tariff (0.83; 0.86), HUI2 (0.77) and HUI3 (0.61) were significantly different, agreement was low to moderate. Change after hearing aid fitting (n = 70) for HUI2 (0.07) and HUI3 (0.12) was statistically significant, unlike the EQ-5D UK (0.01) and Dutch (0.00) tariff. ICERs varied from 647,209 euros/QALY for the EQ-5D Dutch tariff to 15,811 euros/QALY for HUI3.

Conclusion: Utility scores, utility gain and ICERs heavily depend on the measure that is used to elicit them. This study indicates HUI3 as the instrument of first choice when measuring utility in a population with hearing complaints, but emphasizes the importance of a clear notion of what constitutes utility with regard to economic analyses.

Figures

Fig. 1
Fig. 1
Scatterplot of utility scores derived with EQ-5D UK tariff and HUI2
Fig. 2
Fig. 2
Scatterplot of utility scores derived with EQ-5D UK tariff and HUI3
Fig. 3
Fig. 3
Percentage of responses for each level of each attribute before (b) and after (a) hearingaid fitting for EQ-5D, HUI2 and HUI3
Fig. 4
Fig. 4
Incremental cost-effectiveness ratio for hearing aid fitting. Incremental costs (euro) are displayed at the vertical line, incremental effects (QALYs) on the horizontal line
Fig. 5
Fig. 5
Cost-effectiveness acceptability curves of EQ-5D UK and Dutch tariff, HUI2 and HUI3

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